Enhancing photographic AAC displays for children with cortical visual impairment: foundations for accessible design and implementation

PURPOSE: Photographic AAC displays, such as visual scene displays, are gaining recognition as a valuable tool in augmentative and alternative communication (AAC) for their capacity to incorporate familiar objects and contextually rich images that enhance communication. However, it is possible the complexity of some photographic AAC displays may unintentionally obstruct communication for those with cortical visual impairment (CVI) rather than support it. Therefore, investigating design principles that reduce complexity, and foster engagement could improve the effectiveness of photographic AAC displays for children with CVI. MATERIALS AND METHODS: This perspectives paper hopes to lay a foundation for enhancing photographs for those with CVI, discussing strategies to modify photographs to possibly help improve visual accessibility and engagement. RESULTS: Key approaches discussed include considering a) the number of photographic elements and item spacing, b) adjustments to contrast, including brightness, and colour saturation, c) outlining, and d) familiarity, object size, and visual field preferences. This perspectives paper also considers just-in-time (JIT) programming applications for individuals with CVI, providing examples of potential photographic manipulations to explore the feasibility of applying these modifications to real-life photographs. CONCLUSION: By addressing the unique visual processing challenges associated with CVI, these strategies offer a foundation for interdisciplinary collaboration and help serve as a starting point for comprehensively evaluating how various photographic design factors influence AAC outcomes, ultimately supporting improved communication and literacy for this population.